^(99m)Tc-DTPA肾动态延迟显像技术评估泌尿系结石所致重度肾功能受损应用研究

Application of^(99m)Tc-DTPA renal dynamic delayed imaging in the evaluation of severe renal impairment caused by urinary stones

目的探究99m锝-二乙三胺五乙酸(^(99m)Tc-DTPA)肾动态延迟显像技术对泌尿系结石所致重度肾功能受损的应用价值。方法67例泌尿系结石患者,根据影像检查(B超、CT或IVP等)中结石部位可分为肾结石组(38例)和输尿管结石组(29例)。两组均进行^(99m)Tc-DTPA肾动态及延迟显像检查。比较两组肾动态显像肾功能参数[患肾、健肾、总肾肾小球滤过率(GFR)及患肾、健肾峰时和半排时间]、显像率及肾功能改善率。结果肾结石组与输尿管结石组患肾和总肾GFR及患肾和健肾峰时、半排时间比较差异无统计学意义(P>0.05);肾结石组健肾GFR(59.47±11.05)ml/min高于输尿管结石组的(52.38±11.76)ml/min,差异有统计学意义(P<0.05)。肾结石组显像率65.79%和肾功能改善率55.26%均低于输尿管结石组的89.66%、79.31%,差异有统计学意义(P<0.05)。结论^(99m)Tc-DTPA肾动态延迟显像技术可以正确反映出泌尿系不同部位结石所致重度肾功能受损情况,对临床手术治疗方案的选择有一定的参考价值。

Objective To investigate the application value of 99m Tc diethylenetriamine pentaacetic acid(^(99m)Tc-DTPA)renal dynamic delayed imaging in the evaluation of severe renal impairment caused by urinary stones.Methods 67 patients with urinary stones were divided into kidney stone group(38 cases)and ureteral stone group(29 cases)according to the site of stones in imaging(B-mode ultrasound,CT or IVP,etc.).In both groups,^(99m)Tc-DTPA renal dynamic and delayed imaging was performed.Both groups were compared in terms of parameters[glomerular filtration rate(GFR)of the affected kidney,healthy kidney,total kidney,and peak time and half-discharge time of the affected kidney and healthy kidney]of renal dynamic imaging,the imaging rate and the improvement rate of renal function were compared between the two groups.Results The GFR of the affected and total kidney,peak time and half-discharge time of the affected and healthy kidney were compared between the kidney stone group and the ureteral stone group,and the differences were not statistically significant(P>0.05).GFR of the healthy kidney was(59.47±11.05)ml/min in the kidney stone group,which was higher than that of(52.38±11.76)ml/min in the ureteral stone group,and the difference was statistically significant(P<0.05).The imaging rate of 65.79%and the improvement rate of renal function of 55.26%in the kidney stone group were lower than those of 89.66%and 79.31%in the ureteral stone group,and the differences were statistically significant(P<0.05).Conclusion^(99m)Tc-DTPA renal dynamic delay imaging can correctly reflect the severe renal impairment caused by stones in different parts of the urinary system,which has certain reference value for the selection of clinical surgical treatment.